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Module 6 > Substance USE DISORDER > Flashcards

Substance USE DISORDER Flashcards

1
Q

CNS depressants

A

Alcohol
Barbiturates
Benzodiazepines

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2
Q

Barbiturates are more easier to OD than with benzodiazepines….. why is this ?

A

Becuase it Mimic gaba that is not there

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3
Q

Benzodiazepines given for alcohol withdrawal

A

Lorazepam
Diazepam

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4
Q

CIWA score over 15

A

Pretty significant alcohol withdrawal

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5
Q

CIWA score over 20

A

Emergent and we would be in close contact with physician at this point.

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6
Q

What happens if CIWA score stays over 20 for 2 hours after giving lorazepam or diazepam?

A

We would move them to a higher level of care to prevent this

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7
Q

Alcohol withdrawal peaks

A

24-48 hours

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8
Q

Delirium tremens peak

A

2-3 days after cessation and reduction of alcohol

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9
Q

What can be given in reversal of wernicke’s encephalopathy and or even prevent this from happening

A

Thiamine and B vitamins

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10
Q

What is commonly used for alcohol withdrawal ?

A

Benzos- lorazepam

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11
Q

In regard to alcohol withdraw what can be given if benzos are not tolerated?

A

Barbiturates - phenobarbital

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12
Q

When someone is experiencing alcohol withdraw and is having anxiety and possible seizures due to the history of seizures from withdraw.. what can be given?

A

Anticonvulsant………. Gabapentin

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13
Q

What can help when a patient is experiencing autonomic symptoms such as elevated vitals, and intense sweating, during alcohol withdraw?

A

Beta blockers such as propanolol

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14
Q

What is the first in line med of choice for elevated VS during alcohol withdraw?

A

Alpha blocker… Clonidine.

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15
Q

Drugs that help with ETOH sobriety

A

Naltrexone
Acamprosate
Disulfiram
Gabapentin

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16
Q

Naltrexone

A

Reduces rewards from drinking and reduces cravings to help prevent relapse

Reduces euphoria

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17
Q

Acamprosate

A

Helps reduce symptoms of long lasting withdrawal (post acute) helps reduce insomnia , anxiety , dysphoria(negative unhappy feeling)))

Effective in pt w severe symtpoms

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18
Q

Disulfiram

A

Causes unpleasant reactions such as flushing and N&V
When a pt drinks alcohol so it makes them not want to feel the cravings or avoid alcohol

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19
Q

Gabapentin in use for ETOH sobriety

A

Helps calm down the brain so it reduces anxiety and sleep and reduce craving for alcohol

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20
Q

What can we teach the pt about disulfiram

A

To avoid any alcohol products such as hand sanitizer, vanilla, mouth wash, cooking oil.. can produce reaction

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21
Q

A pt is finishing his trial on disulfiram. What is important for the nurse to mention BEFORE he goes home

A

It may stay in his system for 14 days so avoid alcohol based things until then.

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22
Q

A pt who is experiencing severe confusion, drowsiness , lack of coordination and memory loss.. the nurse learns that the pt is experiencing overdose on benzodiazepines. What does she administer to reverse this?

A

Flumazenil

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23
Q

Opiates

A

Opium
Oxycodone
Fentanyl
Heroin
Meperidine
Morphine
Codiene
Methadone
Hydromorphone

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24
Q

Oxycodone

A

Potent and easy to OD if tolerance is not high ..
chewed, crush , snorted or inj IV

Usually what celebrates OD on if they sobered for awhile and try to take the dose they use to take.

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25
Q

Meperidine

A

Potent and taken PO and still feel very high w/o IV stuff

Less constipating
Less urinary retention
Less pupillary constriction so can’t tell when pt is high off this

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26
Q

Intoxication on opiates s/s

A

Constricted pupils
Decrease resp sedation
Decrease bp
Slurred speech
Psychomotor retardation

27
Q

Toxicity triad symptoms opiates

A

Pin point pupils
Resp depression
Coma

28
Q

Toxicity triad symptoms can lead to

A

Shock
Seizure
Cardiac arrest

29
Q

Withdrawal opiates

A

Yawning(neuro)
Insomnia
Irritability
Rhinorrhea , lacrimination
Panic
Diaphoresis cramps n/v/d
Muscle aches
Bone pain
Chills/fever
Increased BP & HR

30
Q

opiate toxicity treatment emergency care

A

1 airway management ..adequate o2

Candidate for intubation
Medication - opioid antagonist

31
Q

Opioid antagonist

A

Naloxone ( short acting)
Nalmefene( long acting)

32
Q

Naloxone

A

Reverse s/s opioid OD
Pt may experience abrupt violent action
We may want to keep multiple doses on hand till toxic level is achieved

33
Q

Nafelmene

A

Long acing
But can make withdrawal symptoms longer and we can expect complaint right after about withdrawal symptoms

34
Q

Methadone

A

Long acting opioid ..for opioid withdrawal
Can be started immediately
Replacing illicit w/ a legal one
We can slowly reduce dose over time

35
Q

Clonidine is used for alcohol withdrawal but can also be used for opioid withdrawal. What does this help?

A

Autonomic s/s such as vitals

36
Q

Sobriety maintence for opioids

A

Methadone
Buprenorphine
Naltrexone
Suboxone

37
Q

Methadone for opioid sobriety

A

Keeps away withdraw symptoms& does not have high..
so they can have a work like and family stuff ..
this also helps to work on coping and life skills
.. give 1x a day and administered only by opioid program

38
Q

Buprenorphine

A

Can be given at med facility but authorized training course..

Reduces craving & relapse ,, mild neonatal with draw
1-3x a wk

39
Q

Naltrexone

A

Blocks euphoric effect of opioids
Seen a lot

40
Q

Suboxone

A

Prevent high from opioids .. combo of Buprenorphine and naltrexone & helps prevent relapse

41
Q

CNS stimulants

A

Cocaine , crack , amphetamines , methamphetamines

42
Q

Short acting CNS stimulants

A

Cocaine
Crack

43
Q

Long acting CNS stimulants

A

Amphetamines
Methamphetamines

44
Q

Cocaine intotoxication

A

Euphoria *
Dilated pupils *
Elevated BP HR *
N/v
Insomnia
Grandiosity
Impaired judgement *

45
Q

Over dose cocaine

A

Resp distress
Ataxia
Hyperpyrexia
Convulsions
Hemorrhagic stroke
Ventricular dysrhythmias
MI
COMA
Death

46
Q

Withdrawal cocaine

A

Fatigue
Lethargy sleepiness
Anxiety ,agitation , insomina
Disorientation
Apathy
Craving
Depression
Suicide ideation *

47
Q

Meth intoxication short term:

A

dialation of pupils
Increase energy
Increase resp
Hyperthermia
Euphoria

48
Q

Long term intoxication w meth

A

Paranoia w delusion s
Hallucinations
Anxiety
Potential for violence *

49
Q

OD in meth

A

Resp distress
Ataxia
Hyperpyrexia
Convulsions
Hemorrhagic stroke
Ventricular dysrhythmias
MI
Coma
Death

50
Q

Withdrawal meth

A

Fatigue, lethargy, sleepiness
Anxiety , agitation , insomnia
Disorientation
Apathy
Craving
Depression
Suicidal ideation
Hungry

Symptoms can go on for months

51
Q

CNS stimulant OD treatment

A

Maintain ABC
Provide o2
Benzo (sedation , prevent seizure)
Cooling measures
Antihypertensives

52
Q

During CNS withdrawal treatment what is given for lethargy

A

Modafinil

53
Q

For CNS stim withdrawal treatment.. what is given for agitation and sleeplessness

A

Diphenhydramine
Trazodone

54
Q

CNS stimulant withdrawal treatment for minor pain

A

Analgesics

55
Q

CNS stimulant withdrawal treatment for sedatives

A

Benzodiazapines

56
Q

Club drugs

A

Ecstasy (MDMA)
gamma hydroxybutyrate GHB
Rohypnol

57
Q

Intoxication of ecstasy

A

Euphoria
Disinhibition
Increased sensuality , empathy , closeness

58
Q

OD on ecstasy

A

Hyperthermia
Seizures
Hypertensive crisis
Cardiac dysrhythmias
Serotonin syndrome

Neuro :confusion ,delirium, paranoia

Cognitive impairment (long term use)

59
Q

Withdrawal ecstasy

A

Profound depression
Confusion
Sleep probs
Anxiety
Cravings

60
Q

Ecstasy OD treatment

A

No antidote
Activated charcoal
Chemistry panel - kidney and liver
Symptom management:
ABC
Cooling measures
Calm quiet enviroment
Sedate w benzo

61
Q

GHB intoxication

A

Euphoria
Disinhibition
Impaired judgment
Feeling drunk
Amnesia
Loss of control over movement
Dizziness
Confusion
Sedation
N/v
Resp depression

62
Q

OD in GHB

A

Cheyne strokes resp
Seizures
Slow breathing
Low HR
Low body temp
Coma
Death

63
Q

Withdrawal GHB

A

Tremors
Insomnia
Anxiety

64
Q

GHB and Rohyphnol treatment

A

antidote: None for GHB &&&& Flumazenil -rohypnol
Activated charcoal
Symptom management :
ABC
Cooling
Calm quiet env
Sedation w benzo

Module 6 (21 decks)

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